Research finding · June 2026
Opioid prescribing patterns may help identify elevated suicide prevention needs
Prescription opioids can play an important role in pain management, but they also require careful monitoring, especially when used at higher doses or over longer periods of time. One concern in suicide prevention is whether greater access to opioid medications may increase risk for self-harm or suicide by poisoning. At the same time, this relationship is not simple: people prescribed long-term or high-dose opioids may also be living with chronic pain, complex health needs, substance use concerns, or mental health conditions that can independently increase suicide risk. Understanding whether opioid prescribing patterns are linked to different methods of self-harm and suicide can help clinicians better identify when additional screening, support, and safety planning may be needed.
With her AFSP-funded work, Dr. Gabrielle Campbell analyzed data from more than 3.2 million adults in Australia who initiated a prescription opioid between 2003 and 2018, examining associations between opioid exposure, dose, duration, self-harm hospitalization, and suicide death. During the study period, there were 49,215 self-harm hospitalizations and 3,086 suicide deaths. Opioid poisoning was the least common method for both self-harm hospitalizations and suicide deaths, suggesting that the relationship between opioid prescribing and suicide risk is more complex than access to opioids alone.
However, among the smaller proportion of events involving opioid poisoning, risk increased with current opioid exposure, longer cumulative duration, and higher daily dose, even after accounting for known suicide-related risk factors. For example, people with 151–180 days of opioid use in the past six months had a higher risk of opioid-related self-harm and suicide than those with no exposure, and the highest daily opioid doses were associated with substantially higher risk of suicide involving opioid poisoning. Overall, the findings suggest that suicide-related behaviors should be screened and monitored among people prescribed opioids, particularly those receiving long-term or high-dose opioid therapy, while recognizing that pain, mental health, and other co-occurring risks may also be central to prevention.
Citation: Campbell, G., Tran, D. T., Bharat, C. I., Degenhardt, L., Draper, B., Pearson, S.-A., … Havard, A. (2025). Risk of self-harm and suicide associated with the use of opioid analgesics. The British Journal of Psychiatry, 1–9. https://doi.org/10.1192/bjp.2025.10436
This finding comes from an AFSP-funded study — see the grant below ↓
